CCCNHL Adult Hockey
Tuesday - Thursday from September 25, 2007 – April 29, 2008
You must be 18 years of age or older!
Fee: Determined by Team Captain
Registration and Payment will reserve your spot on or before September 25Th, 2007!
New players will be placed on a Team, please call the Cornerstone Community Center (920) 403-2000 or email jgerarden@netnet.net .
Send Registration and Check to:
CCC, 1640 Fernando Dr., DePere, WI 54115
Skater's Name: __________________________________________________________
Address: ______________________________________________________________________
Phone: _____________________________Email: ___________________________________
Activity: CCCNHL ADULT Hockey_ TEAM NAME: ____________________________
Liability Waiver
Please read this form Carefully and be aware that in signing up and participating in the program you will be waiving and releasing all claims for injuries sustained arising out of this program, including transportation services, when provided. As a participant in the program I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of injuries, damages or losses which I may sustain as a result of participating in any and all activities associated with such programs. I do hereby release and discharge the and Cornerstone Community Center Inc. and it's officers, agents, volunteers and staff from all claims resulting in injuries or damage and losses due to my participation in the activities provided by these organizations. I further indemnify and hold harmless and defend the named organizations, officers, volunteers and staff all claims resulting from injuries, damages and losses sustained by me and arising out of connection with , or in anyway associated with the activities provided. I have read and fully understand Waiver release of all claims.
Signature:____________________________________Date:____________
*$25.00 Service fee on all returned checks*
